MEDICARE: DR. PHILIP CRAIG OVADIA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME132749	FL
2	208600000X	Surgery Physician	MD426935	PA
3	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD426935	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669405841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP CRAIG OVADIA M.D.

Provider Business Mailing Address
First Line	:	204 37TH AVE N # 289
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1416
Country	:	US
Telephone Number	:	617-480-6639
Fax Number	:	727-351-8042

Provider Business Practice Location Address
First Line	:	204 37TH AVE N # 289
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33704-1416
Country	:	US
Telephone Number	:	727-472-9995
Fax Number	:	727-351-8042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	06/16/2025

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